First, a plastic anoscope coated in an anesthetic gel is inserted into the anus. Then a swab coated in vinegar is inserted through the anoscope and into the anal canal. The vinegar will turn any abnormal cells white.

A colposcope, a tool that provides magnified images. The colposcope provides a clear picture of the anal canal, allowing the doctor to see any abnormal cells.

If any lesions are discovered, a biopsy can be performed during the HRA procedure. A biopsy is the only way to make an actual diagnosis of anal dysplasia. Pain after a biopsy is minimal, and most patients only require over the counter medications like Tylenol or Advil for pain relief.

If a biopsy is performed, the cells will be examined by a pathologist to determine if they represent a low-grade or high-grade lesion. Cancerous cells may also be identified. Low-grade lesions only need to be periodically monitored, whereas high-grade lesions will require further treatment.

How is anal dysplasia treated at URMC?

At the University of Rochester Medical Center, anal dysplasia is treated with Infrared Cautery.

Infrared Cautery (IRC) uses short bursts of infrared light to destroy—or “ablate”—abnormal cells. IRC is performed during an office visit. It is nearly painless and causes minimal bleeding.

Local anesthetics are used to keep you comfortable during the procedure. No suppositories or enemas are required ahead of time. For many patients, two or three treatments will be needed to ensure that all abnormal cells have been destroyed.

After you have had Infrared Cautery for anal dysplasia, you will need regular anal pap tests or HRA to ensure that you have no further issues.